Prognostic impact of chronic kidney disease and renal replacement therapy in ventricular tachyarrhythmias and aborted cardiac arrest

Weidner, Kathrin; Behnes, Michael; Schupp, Tobias; Rusnak, Jonas; Reiser, Linda; Taton, Gabriel; Reichelt, Thomas; Ellguth, Dominik; Engelke, Niko; Bollow, Armin; El‐Battrawy, Ibrahim; Ansari, Uzair; Hoppner, Jorge; Nienaber, Christoph; Mashayekhi, Kambis; Weiß, Christel; Akin, Muharrem; Borggrefe, Martin; Akın, İbrahim

doi:10.1007/s00392-018-1396-y

Cited by 15 publications

(14 citation statements)

References 52 publications

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“…Accordingly, the strongest negative effect on long-term allcause mortality in this study was the presence of CKD in both OHCA and IHCA. Recently, it was shown that the presence of CKD and, especially of renal replacement therapy, was associated with increased long-term mortality among patients with ventricular tachyarrhythmias and aborted cardiac arrest [18]. Hence, among IHCA patients lower lactate and creatinine levels were associated with higher likelihood of survival [19].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

et al. 2021

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Limited data regarding the prognostic impact of ventricular tachyarrhythmias related to out-of-hospital (OHCA) compared to in-hospital cardiac arrest (IHCA) is available. A large retrospective single-center observational registry with all patients admitted due to ventricular tachyarrhythmias was used including all consecutive patients with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Survivors discharged after OHCA were compared to those after IHCA using multivariable Cox regression models and propensity-score matching for evaluation of the primary endpoint of long-term all-cause mortality at 2.5 years. Secondary endpoints were all-cause mortality at 6 months and cardiac rehospitalization at 2.5 years. From 2.422 consecutive patients with ventricular tachyarrhythmias, a total of 524 patients survived cardiac arrest and were discharged from hospital (OHCA 62%; IHCA 38%). In about 50% of all cases, acute myocardial infarction was the underlying disease leading to ventricular tachyarrhythmias with consecutive aborted cardiac arrest. Survivors of IHCA were associated with increased long-term all-cause mortality compared to OHCA even after multivariable adjustment (28% vs. 16%; log rank p = 0.001; HR 1.623; 95% CI 1.002–2.629; p = 0.049) and after propensity-score matching (28% vs. 19%; log rank p = 0.045). Rates of cardiac rehospitalization rates at 2.5 years were equally distributed between OHCA and IHCA survivors. In patients presenting with ventricular tachyarrhythmias, survivors of IHCA were associated with increased risk for all-cause mortality at 2.5 years compared to OHCA survivors.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

et al. 2021

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“…Additionally, most patients with CKD suffer from malignant arterial hypertension due to inadequate volume control, which is a direct cause of left ventricular hypertrophy (LVH) [ 7 ]. LVH is associated with an increased risk of sudden cardiac arrest (SCA), affecting more than 70% of patients receiving RRT [ 6 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…As most patients with OHCA have limited information about their renal function before the cardiac arrest, only a few studies have evaluated the prognostic value of underlying CKD and the requirement for RRT in OHCA patients, but these included a small number of patients with CKD [ 2 , 13 , 16 ]. Thus, in clinical practice, it would be beneficial if the outcomes after cardiac arrest could be predicted using knowledge about the underlying CKD and ongoing RRT.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Effect of Underlying Chronic Kidney Disease and Renal Replacement Therapy on the Outcome of Patients after Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study

et al. 2022

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Background and Objectives: This study assessed the prognostic value of underlying chronic kidney disease (CKD) and renal replacement therapy (RRT) on the clinical outcomes from out-of-hospital cardiac arrest (OHCA). Materials and Methods: This retrospective study was conducted utilizing the population-based OHCA data of South Korea between 2008 and 2018. Adult (>18 years) OHCA patients with a medical cause of cardiac arrest were included and classified into three categories based on the underlying CKD and RRT: (1) non-CKD group; (2) CKD without RRT group; and (3) CKD with RRT group. A total of 13,682 eligible patients were included (non-CKD, 9863; CKD without RRT, 1778; CKD with RRT, 2041). From the three comparison subgroups, data with propensity score matching were extracted. The influence of CKD and RRT on patient outcomes was assessed using propensity score matching and multivariate logistic regression analyses. The primary outcome was survival at hospital discharge and the secondary outcome was a good neurological outcome at hospital discharge. Results: The two CKD groups (CKD without RRT and CKD with RRT) showed no significant difference in survival at hospital discharge compared with the non-CKD group (CKD without RRT vs. non-CKD, p > 0.05; CKD with RRT vs. non-CKD, p > 0.05). The non-CKD group had a higher chance of having good neurological outcomes than the CKD groups (non-CKD vs. CKD without RRT, p < 0.05; non-CKD vs. CKD with RRT, p < 0.05) whereas there was no significant difference between the two CKD groups (CKD without RRT vs. CKD with RRT, p > 0.05). Conclusions: Compared with patients without CKD, the underlying cause of CKD—regardless of RRT—may be linked to poor neurological outcomes. Underlying CKD and RRT had no effect on the survival at hospital discharge.

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“…Even with successful ablations, the long-term outcome remains unsatisfactory due to the persistent high mortality rates within the first 5 years [2][3][4]. Advanced New York Heart Association (NYHA) class, low left ventricle ejection fraction (LVEF), elevated left ventricular end-diastolic volume (LVEDV), ischemic cardiomyopathy (ICM), electrical storm (ES) with recurrent shocks, advanced age as well as frequent comor- bidities such as lung disease, diabetes mellitus (DM), renal dysfunction and atrial fibrillation (AF) are all associated with poor prognosis [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Role of assist device implantation and heart transplantation in the long-term outcome of patients with structural heart disease after catheter ablation of ventricular tachycardia

Darma

Bertagnolli

Dinov

et al. 2021

Herzschr Elektrophys

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Introduction Ablation of ventricular tachycardias (VTs) in patients with structural heart disease (SHD) has been associated with advanced heart failure and poor survival. Methods and results This matched case-control study sought to assess the difference in survival after left ventricular assist device (LVAD) implantation and/or heart transplantation (HTX) in SHD patients undergoing VT ablation. From the initial cohort of 309 SHD patients undergoing VT ablation (187 ischemic cardiomyopathy, mean age 64 ± 12 years, ejection fraction of 34 ± 13%), 15 patients received an LVAD and nine patients HTX after VT ablation during a follow-up period of 44 ± 33 months. Long-term survival after LVAD did not differ from the matched control group (p = 0.761), although the cause of lethal events was different. All post-HTX patients survived during follow-up. Conclusion In this matched case-control study on patients with SHD undergoing VT ablation, patients that received LVAD implantation had similar survival compared to the control group after 4‑year follow-up, while the patients with HTX had a significantly better outcome.

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Prognostic impact of chronic kidney disease and renal replacement therapy in ventricular tachyarrhythmias and aborted cardiac arrest

Cited by 15 publications

References 52 publications

Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

Clinical outcome of out-of-hospital vs. in-hospital cardiac arrest survivors presenting with ventricular tachyarrhythmias

Prognostic Effect of Underlying Chronic Kidney Disease and Renal Replacement Therapy on the Outcome of Patients after Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study

Role of assist device implantation and heart transplantation in the long-term outcome of patients with structural heart disease after catheter ablation of ventricular tachycardia

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